Lancet: Feed Children during the First 1000 Days of Life for Economic Prosperity

Thursday, June 27, 2013

A timely report has been issued by leading medical journal Lancet as the United Nations determines the new development goals for the world. The Series, Maternal and Child Nutrition, issues an urgent plea to governments to make nutrition during the first 1000 days of life--from conception to the second birthday--and for adolescents and women of reproductive age, the center of the new development goals. The authors argue that malnutrition is the underlying cause of death for at least 3.1 million children a year and is responsible for 45% of all deaths among children under the age of five. More than 800,000 babies--one in four newborns--die each year because they are born too soon or too small as a result of poor maternal nutrition.

Malnutrition also results in the stunted growth of 165 million children resulting in impaired physical and cognitive development with lasting detriment to the individual and to the economic health of countries. The reports demonstrate that greater commitments and investments in the first 1000 days of life can save the lives of both mothers and children and help countries thrive.

"The Maternal and Child
Nutrition Study Group emphasizes ten interventions targeted to women of
reproductive age, during pregnancy, and to infants and children. They calculate
the effects of these interventions in 34 countries across Africa, Asia, and the
Middle East, where 90% of the global burden of undernutrition resides. In doing
so, they reinforce the importance of the first 1000 days from conception to 2
years. What goes right and what goes wrong for fetal and child nutrition during
this period has lasting and irreversible consequences for later life.

There are several entirely new findings in this Series. First, the adolescent girl is identified as especially vulnerable to the effects of undernutrition. But that very predicament also makes adolescent girls a group with a special opportunity too."

Robert E Black highlights in Maternal and child nutrition: building momentum for impact the need to ensure that women of reproductive age are prepared with nutrition and vitamins for healthy pregnancies:

"The new evidence provided in the Maternal and Child Nutrition Series strengthens the case for a continued focus on the first 1000 days. Investments within this window can help meet crucial goals: the prevention of undernutrition, overweight, and poor child development outcomes with longlasting effects on human capital formation.

Because many women do not access nutrition-promoting services until month 5 or 6 ofpregnancy, we draw attention to the need to ensure women enter pregnancy in a state of optimum nutrition. Nutrition is foundational to both individual and national development. The post-Millennium Development Goals agenda must put the resolution of all forms of malnutrition at the top of its aims."

Anna Taylor writing in Only collective action will end undernutrition also emphasizes the importance of preparing adolescents and women of reproductive age for pregnancy and placing this urgency at the center of the post 2015 Agenda:

"We are in a race against time to eradicate the global scourge of undernutrition. Undernutrition cripples global economic growth and development, and future global prosperity and security are intimately linked with our ability to respond adequately to this urgent challenge. Its results stunt the physical growth and life chances of millions of people, and for Africa and Asia estimates suggest that up to 11% of national economic productivity is lost to undernutrition.

Women and girls are at the heart of this message. As the bearers and carers of children, their health and economic potential is entwined with that of future generations. Unless girls grow well in early childhood and adolescence and enter into motherhood well nourished, are lent support during pregnancy, protected from heavy physical labour, and empowered to breastfeed and provide good food for their babies and toddlers, the intergenerational cycle of undernutrition will not be broken.

Global efforts on food and nutrition will likewise be substantially boosted by a clear signal of nutrition priorities in the post-2015 development agenda. This agenda will do more than steer aid; it should provide direction on global investment, buy in support from the private sector, and encourage a coherent approach from international institutions. Nutrition should be centrally positioned in that agenda to ensure energy and nutrient needs are met at each stage of life."

Horton concludes his summary by commenting on the report by Stuart Gillespie The politics of reducing malnutrition: building commitment and accelerating progress stating:

Instead of exhorting politicians and policy makers to do something--or worse, simply hoping that political commitment will appear like a rabbit out of a hat--they set out a practical guide about how to seize the agenda for nutrition, how to create political momentum, and how to turn that momentum into results. This is the prize we have to grasp in the next 18 months.

Interventions to grasp the prize of reduced malnutrition include exclusive breastfeeding and appropriate, healthy foods for infants; providing micronutrient powders and fortified foods and sufficient vitamins and minerals to mothers and children; and the prevention and treatment of cases of acute, severe malnutrition throughout childhood.

Lancet estimates the cost of reducing malnutrition related deaths of children under age 5, by 1 million a year across 34 targeted countries, to be $9.6 billion yearly. Aid for basic nutrition came to $418 million in 2011. Governments are strongly urged to unite with businesses and private donors in efforts to eliminate malnutrition, save lives and improve a country's economy.

The perspective presented by this latest Lancet report is one that population control and pro-abortion groups are not likely to embrace. The concept of assisting adolescent girls prepare for their future role as mother is complete

anathema to organizations that work not only to prevent reproduction but that destroy newly conceived life through abortion.

Donor country aid for nutrition programs targeting the first 1000 days of life, however, is increasing as simple interventions to prevent and treat malnutrition not only reduce maternal and child mortality but dramatically improve a country's economy.

PNCI highly recommends the Lancet Series to lawmakers serving in all levels of government who are committed to saving the lives of young children--those living in the womb and those already born--and to saving the lives of their mothers.